How Does Medicare Work
Question: What is Skilled Nursing/Rehabilitation?
According to the Centers for Medicare and Medicaid Services (CMS):
- Skilled care is health care given when you need skilled nursing or rehabilitation staff to manage, observe, and evaluate your care. Examples of skilled care include intravenous injections and physical therapy. Medicare will only cover skilled care when you meet certain conditions.
Question: When and how long will Medicare cover Skilled Nursing Services/Rehabilitation?
Certain criteria have to be met before Medicare will cover under the Skilled Nursing Benefit...
- You have a qualifying inpatient (not observation status) hospital stay of three (3) consecutive midnights
- The skilled care is reasonable and necessary for diagnosing and treating your condition
- You receive these services at a Skilled Nursing Facility certified by Medicare
- If you meet the above criteria, you may qualify for up to 100 days of Skilled Nursing Services
Question: How much is covered by traditional Medicare?
|Days||Medicare Pays for covered services||You pay for covered services|
|1 - 20||Full Cost||Nothing|
|21-100||Everything beyond the daily co-payment||Daily co-payment of $148.00*|
|Beyond 100||Nothing||Full Cost|
*this co-payment may be covered by your secondary insurance policy if you have oneThe Wesleyan at Scenic 2001 Scenic Drive Georgetown, TX 78626 Phone: 512-863-9511